Meletios A. Dimopoulos from the School of Medicine, Athens, Greece, presented results from the phase III Tourmaline-MM3 clinical trial.1 This randomized, placebo-controlled study examined the safety and efficacy of maintenance therapy using the proteasome inhibitor (PI) ixazomib.

The rationale behind this study relies on the fact that lenalidomide, the approved immunomodulatory (IMiD) drug for maintenance therapy, results in treatment-emergent adverse events (AEs) in 29% of the treated patients. It is possible that a PI, which has a different mode of action to that of lenalidomide, may be better tolerated and may provide a more effective maintenance alternative, at least to a subgroup of patients.

The primary endpoint was progression-free survival (PFS) and the key secondary point, overall survival (OS). The results presented at ASH 2018 were recently published at Lancet.2

Results are presented as ixazomib maintenance versus (vs) placebo.

Study Design:

Key inclusion criteria:

Induction therapy comprised of a PI and/or IMiD but not vincristine, doxorubicin, and dexamethasone (VAD)

PFS = 26.5 months vs3 months (HR, 0.72; 95% confidence interval [CI], 0.582–0.89, P = 0.002); there was a significant 39% improvement in overall PFS from time of randomization for the ixazomib group compared to the placebo group

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